Becoming a Therapist 101
Becoming a Therapist 101
Written by: Janine ChengPublished on September 17, 2024There are many paths to becoming a therapist.
Below is a general guide to help you better understand your options and where to start. Should you wish to ask me more detailed questions, please feel free to book a consultation with me
Degrees
Below is a non-exhaustive list of degrees/educational tracks that can lead to licensure as a practicing therapist. Each degree offers its own advantages and drawbacks as well as slightly different areas of focus. As you evaluate which educational path to pursue, I recommend researching therapist job postings in your area to assess which degrees are most in demand. In New York, for instance, Social Workers (LMSWs and LCSWs) are most sought after. This will vary from state to state.
Masters in Social Work
Completing a Masters in Social Work is a very popular and accessible way to become a licensed therapist. Social work graduate programs involve two years of combined coursework and practical learning through an internship, both of which will be tailored based on your selected areas of focus: typically Community Organizing, Clinical Practice, or Non Profit Management. These may differ based on the program/school you select.
Unfortunately, internships are unpaid and field placements can vary widely in the quality of experience they offer. Students who are already working in a clinical or otherwise relevant role may be able to use their employer as a field placement, but this could require some negotiation with your field department. Programs also offer part-time coursework/internship tracks, which may allow you to continue working.
New York has a number of excellent social work programs including at NYU, Columbia and Silberman School of Social Work.
Graduate Social Work program coursework typically covers areas of study related to social policy, advocacy and community resources, culture, society, and inequalities, social work research methods, community mental health, family and child welfare. Elective courses will allow for a more specialized focus on diagnosis and treatment of emotional, behavioral, and mental disorders, ethical treatment practices, biological basis of behavior, etc.
LCAT, LMHC, LMFT, LMHC
You may also consider programs that offer a more specialized focus that aligns with your areas of interest. For example: LCAT: Licensed Creative Arts Therapist, LMHC: Licensed Mental Health Clinician, LMFT: Licensed Marriage and Family Therapist. Each one of these programs has a specific lens through which it approaches patient work. If you are unsure of your area of interest but know that you would like to explore a clinical track, the LMHC option may be a good fit. These programs will also involve a combination of coursework and an internship.
PsyD/PhD
Doctorate programs in psychology offer highly specialized training in clinical practice and research. Programs are long and expensive, but may allow you to bill at much higher rates once in practice.
Licensing
Regardless of the educational track you select, you will need to obtain licensure upon graduation. Once you complete your Social Work program, for instance, you will need to sit for your licensing exam, which will test your understanding of the material covered in school. Passing the exam allows you to practice as a Licensed Master Social Worker (LMSW) in New York. Although LMSWs cannot independently see patients or bill insurance, they can practice under the supervision of a Licensed Clinical Social Worker (LCSW). This means that they can provide mental health treatment to patients, but will need to have weekly or biweekly supervision with an LCSW to discuss their work. Most employers will offer clinical supervision as part of your employment. LMSWs can also pay for external clinical supervision. This can range in cost from $50-$150 per individual or group supervision session. These rates are likely to vary based on the state in which you practice.
Clinical Hours
Licensed Master Social Workers can begin to accrue clinical hours under the supervision of an LCSW. This may be done in a clinic setting, through a group practice, as a school social worker etc. LMSWs must complete 2000 hours of clinical work under LCSW supervision over the course of at least 3 years to become eligible to sit for the Clinical Licensing exam. Passing this exam allows you to practice independently, open a private practice and bill insurance as a Licensed Clinical Social Worker.
Additional Training/Specialties
Throughout your schooling and as you begin to gain clinical experience, I highly recommend pursuing additional training in specific treatment modalities. This is your opportunity to hone your craft and develop an area of expertise. Patients are much likelier to seek your services and you are much likelier to meet their needs if you have a speciality. As you begin to practice and have exposure to different treatment settings/patient populations, you will get a better sense of your areas of clinical interest, the approaches that most resonate with you and the clients with whom your skills are most effective. You may choose to focus on work with couples, trauma survivors, patients living with ADHD, eating disorders, anxiety. Accordingly, you may seek specialized training in Cognitive Behavior Therapy, Somatic Experiencing, Dialectical Behavior Therapy, Family Therapy, etc.
Career Options/Income Potential
As a Licensed Clinical Social Worker, you have a number of career options. You can start your own practice, practice out of an established group practice, as school-based therapist, at an outpatient mental health clinic, in a hospital setting etc.
School-based counselors have summers off and can make upwards of $100,000 depending on their years of experience, but starting salaries usually begin around $60,000. This work is slightly less clinical in nature and will resemble counseling more than intensive mental health treatment. Caseloads can also be very high, but you will be working in a setting that grants you access to an important area of your patient’s life-school.
Salary potential at an out-patient mental health or community-based clinic will be significantly lower, ranging from $50,000 to $80,000 depending on years of experience and position. In this setting, you will however have the opportunity to hone your clinical skills. You will likely work with a wide range of patients and have ample opportunity to learn how to diagnose, develop treatment plans and practice a variety of clinical interventions.
Hospital settings offer competitive salaries with comprehensive benefits. Interventions may be shorter, in alignment with patient admissions and discharges.
Private practice offers a great deal of flexibility in your schedule and income. LCSWs can bill insurance and receive reimbursements upwards of $130 per session or bill for out of pocket treatment at $100-$250 per session, which can amount to an annual salary ranging from $100,000 to $250,000. That being said, building a caseload can take time and there can be some unpredictability in income. Therapists in private practice also need to secure their own health insurance, which can prove costly.
Regardless of the path you choose, know that you are embarking on an important journey, one that is sure to enrich your life and the lives of your clients.
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